Mirizzi综合征的诊治探讨

Diagnosis and treatmemt of Mirizzi' s syndrome.

目的 探讨Mirizzi综合征的诊断及外科手术治疗的术式。方法 回顾性总结分析 2 8例Mirizzi综合征病人的临床资料。结果 2 8例病人分别行胆囊切除或部分胆囊切除 ,直接瘘口修补或胆囊壁补片修补及Roux en Y式肝总管十二指肠吻合术或空肠吻合术。所有病人均痊愈出院。结论 术前明确诊断可减少Mirizzi综合征术中胆道损伤的发生率 ,手术方式依据病理分型而定。内镜逆行性胰胆管造影 (ERCP)及B超是术前明确诊断的主要手段。

Objective To investigate the diagnosis and surgical management of Mirizzi' s syndrome. Methods The clinical manifestations of 28 patients with Mirizzi' s syndrome were analyzed retrospectively.Results Cholecystectomy,partial cholecystectomy,direct closure of fistula or closure with gallbladder wall patch,and Roux en Y hepaticojejunostomy or hepaticoduodenostomy were performed for these 28 patients individually,and all of them were cured.Conclusion Correct preoperative diagnosis can decrease the occurrence of bile duct injuries during operation,and which kind of operation we performed should be according to the pathologic type of the Mirizzi' s syndrome.ERCP and B ultrasound are the important methods in the preoperative diagnosis of Mirizzi' s syndrome.